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Background & Aims: Epidemics of human viruses began during the period of Neolithic around 12,000 years ago. Humans developed more densely population which allowed viruses to spread rapidly among communities. Also, plant and livestock viruses increased along with human viruses (2). At the January 2020, the coronavirus disease (COVID-19 7th human coronavirus) was discovered in Wuhan, Hubei province of China. COVID-19 virus caused six million deads in the world to date and cussed infection of more than seven million of cases in Iran (1). This infectious disease caused by the SARS-CoV-2 virus. This virus was contagious and fast-spread. Despite the aquarantine politics, SARS-CoV-2 virus caused many permanent economic and health damages in most countries. Coronaviruses are positive-sense, single- stranded enveloped RNA viruses with helical capsids that infect a wide range of hosts including humans, bats, other mammals, and birds (2). Coronaviruses are belonging to Nidovirales order, Coronaviridae family, Coronovirinae subfamily and four genera of alpha, beta, delta, and gamma. Alpha and beta coronaviruses are known as human infection agents. SARS-COV-2 virus abilities are including: high mortality number, short period of incubation, widespread transmission protocols, asymptomatic infection and affecting on most vital organs (heart, brain, lungs and ...) which have attracted the health system attention and caused neglect to the other chronic and non-communicable diseases (4). Therefore, the disease incidence, prevalence and prioritization around the world may change in the future. From the beginning of COVID-19 pandemic, some symptoms and risk-factors have been introduced to the world as the increase elements of morbidity and mortality. Studies have shown that having any kind of underlying diseases and risk factors will be effective in the COVID-19 disease severity and mortality (6). Some of these important risk factors are including of chronic kidney disease, hypertension, age, gender, obesity, obstructive pulmonary diseases, diabetes, lung diseases, cardiovascular diseases, cancer, and liver disease. Also, each risk factors have different impact in different geographic areas (7). Some factors, such as different viral load kinetics in each individual person, epidemiological history, therapeutic or pharmacological effects and immune response have some major impacts on the laboratory diagnostic results. Due to the successive mutations of the SARS-CoV-2 virus and the high incidence disease, it seems that the vaccination alone cannot prevent the COVID-19 (9). On the other hand, the World Health Organization has warned about the vaccination as the only pandemic control protocol. Therefore, the prevalence of morbidity and mortality have become the public health concerns in the world since the beginning of the COVID-19 epidemic and the vaccination. Recognizing of the risk-factors and symptoms on COVID-19 in different geographic areas can be a helpful source to prevent the mortality. Understanding risk factors can help the world to control of the coronaviruses pandemic period and similar situations in the future. Therefore, the aim of this study was to determine the risk-factors of mortality of COVID-19 patients in three cities of Khuzestan province, Iran. Methods: This research was an analytical cross-sectional study. Some details of 27963 COVID-19 patients such as clinical symptoms, individual characteristics and underlying diseases were gathered from hospitals in Abadan, Shadegan and Khorramshahr cities in Khuzestan province, Iran, from 20 February 2020 to November 2020. All the under-study population was previously investigated in terms of COVID-19 infection by the medical examinations and laboratory methods. This under-study population was categorized into three different groups such as hospitalized, outpatients and dead patients. Hospitalized patients have admitted in general or ICU (Intensive Care Unit) sector. Obtained database of COVID-19 patients was analyzed by IBM SPSS version 22.0 under regression, logistic model (u
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The changes in the fields of education, business administration, transportation, science and technology innovation, logistics and supply chain management, etc. caused by the COVID-19 pandemic in the post-epidemic era are reviewed in this paper, with research topics such as China's management of medical and health institutions, public health emergency governance, community governance, and national governance being emphasized. The "resilient governance" which is more flexible and resilient has become the common choice both at the national governance level under the background of globalizaiton and at the emergency of public health governance level which pays more attention on the community governance. At the same time, building an institutional coordination and collaboration mechanism that is more adaptable to the post-epidemic era is also a major challenge to future governance. Based on the above analysis, this paper conducts an in-depth analysis of the vague definition of the concept of "post-epidemic era", and discusses the current problems of inadequate use of research methods, inadequate research design, and separation of theoretical and practical values of the research. Finally, from the perspective of restructuring, the future governance concepts and governance models in the post-epidemic era are prospected.
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Purpose: This research aims to test the simultaneous effects of the perceived threat of COVID-19, e-health literacy, e-health access barrier, loyalty toward healthy foods in general, loyalty toward functional foods, the affordability of healthy foods in general and the affordability of functional foods on health-related quality of life (HrQoL) during the COVID-19 pandemic. Design/methodology/approach: A survey with 400 respondents in Banten, Indonesia, was performed. The data were analyzed using multiple regression analysis. Findings: The results of the research showed that HrQoL during the COVID-19 pandemic was positively affected by e-health literacy and the affordability of healthy foods in general while negatively affected by the e-health access barrier, the perceived threat of COVID-19 and loyalty toward healthy foods in general. Furthermore, HrQoL was not influenced by loyalty toward and affordability of functional foods. Research limitations/implications: This research was conducted in Banten. Due to the operational limitations during the COVID-19 pandemic, this research used a purposive sampling technique. Therefore, the next research should retest the model in different contexts and locations. Practical implications: To improve HrQoL during the COVID-19 pandemic, citizens need to be educated on finding and utilizing credible online health information during the COVID-19 pandemic. Governments and health service providers should also strive to offer ease of access to credible online health information. Furthermore, the affordability of healthy foods, in general, should be managed well. Originality/value: A few studies on HrQoL during COVID-19 pandemic were performed. However, there is a lack of paper that examines the role of food customer loyalty and affordability in a model of HrQoL during the COVID-19 pandemic. To the best of the authors' knowledge, this paper is the first that involved and tested the role of food customer loyalty and affordability in a model of HrQoL during the COVID-19 pandemic. © 2023, Emerald Publishing Limited.
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Chinese village doctors, the "gatekeepers" of rural residents' health, shoulder heavy responsibility of providing basic public health services (BPHS) for rural residents. The health-care reform on BPHS launched in 2009 has much influenced village doctors as well as the delivery of health service. This chapter has depicted the challenges and struggles facing Chinese village doctors in the BPHS. COVID-19 is the specific setting for a better understanding of a more real situation. The findings suggest that the diverse roles that the village doctors display as well as the multiple challenges faced by village doctors in the setting of China's prevention and control against COVID-19, however, make the supply of rural medical services uncertain and unsustainable, which would undermine China's reform of primary medical and health care system. © 2023 Nova Science Publishers, Inc.
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Community health workers (CHWs) are the main bridge between health services and the community, and therefore play a vital role in the COVID-19 response. The aim of this study was to determine the COVID-19-related health status of CHWs, their basic knowledge of the disease and the role they played in the pandemic response in 2020. A descriptive cross-sectional study was conducted with CHWs working in Campo Grande between December 2020 and January 2021. The data were collected using an electronic questionnaire. Around 40% of the sample reported at least one risk factor for COVID-19, 44% had experienced at least one COVID-19 symptom, and 76% had experienced symptoms of mental suffering during the first year of the pandemic. Mental suffering was associated with the onset of flu-like symptoms after the start of the pandemic and changes in work processes. Knowledge gaps were observed, mainly related to forms of transmission and disease prevention. In view of the uncertainty about how long this health emergency will last and the vital role CHWs play in the Brazilian Health System, health managers and society need to pay greater attention to these professionals in order to improve the effectiveness of the country's COVID-19 response. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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COVID-19 has been described by many health science professionals worldwide as an extremely challenging condition due to the social, economic, political, and health impacts experienced since the disease occurred. COVID-19 is primarily transmitted through droplets which spread the virus when an infected person coughs, sneezes, or exhales and a person can be infected by breathing in the virus when they are near someone who has COVID-19, or by touching a contaminated surface then touching their eyes, nose, or mouth. Health statistics, including prevalence and mortality/fatalities, provide a necessary understanding of the importance of preventive actions that should be addressed globally. Taking into consideration the global statistical data, it is important to evaluate past pandemics and analyze how nations managed these during their dire times. Through historical knowledge, we can learn how to be more efficient with the COVID-19 pandemic. Health control measures suggested by the WHO and other governments have attained positive results in terms of preventing COVID-19 while diminishing mortality rates. Public health interventions are necessary and may include, public health surveillance, motivational programs for community testing, vitamin and mineral supplementation to enhance immunologic system, and law enforcement to assist communities in obeying national public health actions/statutes that need additional enforcement to prevent COVID-19 transmission. Although not all communities possess all the resources which prove helpful in controlling COVID-19, coordination with other health facilities and communities that do have resources and educational interventions can help prevent major issues that will emerge while reducing serious consequences. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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This study aims to analyze the care trajectories of patients diagnosed with COVID-19 who were hospitalized and are currently undergoing rehabilitation regarding their use of and access to the healthcare network (HN). An evaluative, qualitative study was carried out based on interviews with patients in the city of Niteroi, Rio de Janeiro State, Brazil. The care trajectories were reconstructed at three different occasions that express their experiences with the healthcare and support network during the pandemic: prevention, support and diagnosis measures;hospitalization;postCOVID-19 care, rehabilitation and support. The results indicate that the main source of information about COVID-19 was TV newscasts. Preventive hygiene measures were the most widely adopted. The family was the main support network. There was no waiting time for admission to the municipal referral hospital. Hospitalization was very well evaluated in terms of user embracement, multidisciplinary care, virtual visits and daily contact between doctor and family members. A post-discharge "care vacuum" was identified, with no follow-up by primary health care (PHC) and other public services. Low-cost health insurance plans and private specialized post-COVID-19 services were frequently and spontaneously sought until the implementation of the rehabilitation service. In summary, solitary and discontinuous care trajectories of individuals and families shed light on several challenges to the health system, including guaranteed access to coordinated PHC and expanded offer of specialized public services and rehabilitation, aligned with the principles of humanized care, in addition to the maintenance of social support measures.
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The challenge of maintaining a standard of treatment has become a core issue due to the COVID-19 outbreak, and many countries are currently addressing this issue. Since public health policymaking is a multidimensional issue, including different aspects, measures, features, and scales, and so forth, multidimensional definitions of reasonable medical treatments may improve planning and performance standards for public health systems. This study emphasizes the need to settle all of the dimensions in policymaking to aim to elicit reasonable medical treatment definitions and adequacy assessments from diverse healthcare stakeholders and offer a universally applicable reasonable medical treatment formula. Interviews of thirty-two stakeholders were qualitatively analyzed and mapped onto an innovative quadrilateral model. The findings showed that most interviewees viewed the system positively. However, they identified various lacunas-clinical/service, social/ethical, legal, and economically reasonable medical treatment aspects. A generic formula for the medical sub-services' activity accounted for these, given any specific time period and technological development. The stakeholders' positive assessment reflects an acquiescence for resource allocation and policy enforcement, rather than optimal healthcare. Nationally, this should be addressed. The quadrilateral mapping of the stakeholders enhances the translatability and generalizability of the systemic data. A comprehensive reasonable medical treatment formula will help the policymakers to optimize services, and it will render healthcare planning/implementation transparent, effective, and responsible.
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The separate governments in England, Scotland, Wales, and Northern Ireland have been in charge of planning and executing health care services since devolution in the late 1990s. Residents of the UK have access to a National Health Service (NHS) based on clinical need, not financial capacity. Contrarily, free access to social care services is means-tested and subject to a variety of eligibility requirements depending on the United Kingdom country. In comparison to the majority of other high-income nations, the UK has significantly lower levels of physicians and nurses, hospital beds, and diagnostic tools. Due to these deficiencies, the nation has minimal capacity to absorb sudden shocks like the COVID-19 pandemic. Additionally, they have caused an increase in the number of people on waiting lists for elective care, with over 6 million people in England alone in 2022. In the past, the UK's health spending has seen periods of both continuous expansion and austerity. Nevertheless, over the past ten years, total health spending has grown, reaching just over 10% of GDP in 2019. Around 80% of all health spending is public money, which is a significant share and has been stable over the past 20 years. As a result, UK people have little out-of-pocket spending and high levels of protection from the financial effects of illness. To enable real integration amongst health care providers, a number of obstacles still exist in all four countries, including disconnected health information technology systems, duplicate governance structures, and a dearth of strategic planning. Although efforts to encourage such integration through cross-sectoral partnerships have advanced in England, Scotland, and Wales in recent years, Northern Ireland remains the only United Kingdom component county where the NHS and social care are completely organisationally linked.
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The Public Health Service (PHS) in Germany has had difficulties in recruiting enough qualified staff for years, but there is limited research on what factors drive decisions to (not) join the PHS workforce. We explored reasons for this perceived (lack of) attractiveness. We conducted two cross-sectional surveys among medical students (MS), public health students and students from other PHS-relevant fields (PH&ONM) in Germany before (2019/2020) and during the COVID-19 pandemic (2021). Both waves surveyed self-reported reasons for why students did (not) consider working in the PHS as attractive and how this could be improved, using open-question items. Qualitative and quantitative content analyses were conducted according to Mayring. In total, 948 MS and 445 PH&ONM provided valid written responses. Reasons for considering the PHS as attractive were, among others, the perception of a good work-life balance, high impact, population health focus, and generally interesting occupations. Suggestions to increase attractiveness included reducing bureaucracy, modernization/digitalization, and more acknowledgement of non-medical professionals. Among MS, reasons against were too little clinical/patient-related activities, low salary, and occupations regarded as boring. Our findings indicate areas for improvement for image, working conditions in, and institutional structures of the PHS in Germany to increase its attractiveness as an employer among young professionals.
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COVID-19 , Pandemics , COVID-19/epidemiology , Cross-Sectional Studies , Germany , Health Services , Humans , Prospective Studies , Surveys and QuestionnairesABSTRACT
As in many European countries, the Public Health Service (PHS) in Germany has had considerable difficulties in attracting well-qualified personnel for decades. Despite ongoing political and societal debate, limited empirical research on possible causes and explanations is available. To identify areas of action, we explored reasons for the (lack of) interest in working in the PHS by conducting two cross-sectional surveys among 3019 medical students (MS), public health students, and students from other PHS-relevant fields (PH&ONM) in Germany right before (wave 1, 2019/2020) and during the COVID-19 pandemic (wave 2, 2021). While interest in working in the PHS among MS was low, it was considerably higher among PH&ONM. The prevalent underestimation of the importance of public health and low levels of knowledge about the PHS were identified as potential barriers. Although core activities of the PHS were often considered attractive, they were repeatedly not attributed to the PHS. A negative perception of the PHS (e.g., it being too bureaucratic) was prevalent among students with and without PHS interest, indicating that both a negative image and potentially structural deficits need to be overcome to increase attractiveness. Based on the findings, we propose approaches on how to sustainably attract and retain qualified personnel.
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COVID-19 , Pandemics , COVID-19/epidemiology , Cross-Sectional Studies , Germany , Health Services , Humans , Public Health , Surveys and QuestionnairesABSTRACT
During the COVID-19 pandemic, doctors faced an unprecedented mass admission of patients with viral atypical pneumonia. The objective of the study was to compare the clinical characteristics of the first and second waves of the pandemic. An analytical observational study was carried out on patients with COVID-19 pneumonia who were admitted to Hospital Carrion de Huancayo, Peru located at more than 3000 meters above sea level. Two study periods were determined, group one represented by the first wave characterized by massive restriction and strict quarantine and the second wave where productive activities had already normalized to a great extent. Of a total of 252 patients with COVID-19, the average age was 56 years in the first wave and 52 years in the second wave, the male sex was more frequent in both 74% and 57%, mortality was 27% and 23%, the time of illness was 8 days and 10 days, respectively. On the other hand, the percentage of use of antibiotics, ivermectin and hydroxychloroquine was higher in the first wave. The use of corticosteroids and prolonged hospital stay was more frequent in the second wave. Comparison of both waves shows differences in age, mortality and time of illness, which may be due to the new molecular variants of SARS-COV-2.
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On the whole, poor countries in Africa and elsewhere seem to have weathered the coronavirus (SARS-CoV-2, or COVID-19) pandemic better than wealthier countries with superior healthcare systems. Using the Ghanaian case, this paper draws on newspaper articles, policy statements, and other secondary sources to explain how the country's competitive clientelist political settlement mediated the public health outcomes of the pandemic. It argues that while it lacks overall state capacity, Ghana was able to surmount the limitations of its weak and underresourced public health system by leveraging 'residual capacity' from previous public health programmes and a strong proactive response from the continental and subregional organizations. The government's strong early response enabled it to gain control of the situation in the crucial first few months of the outbreak. However, with an upcoming election later in the year and unwilling to bear the political costs of sustaining its initial efforts, the government subsequently wavered in its response. The country's infection and death rates spiked and dipped in response to these waves of enforcement. The paper concludes with a brief discussion of the limits of 'residual capacity' in public service delivery.
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Building a strong public health system has become an urgent task in the new era. Based on more than eight years of systematic research, we believe that five aspects need to be prioritized for a strong system. First, we should change the perspective on public health, using the word "gonggong jiankang" to replace "gonggong weisheng" and the word "gonggong jiankang tixi" to replace "gonggong weisheng tixi", to lead the public health system development. Second, we should develop a suitable public health system and continuously improve the health capacity for governance. Third, we should make it clear that the goal of building a strong system is not far-fetched, and we need to consolidate the existing institutional advantages of China's public health system: when encountering major problems, we can maintain a unified goal and mobilize the whole society to cooperate effectively to accomplish the goal. However, we need to make up for shortcomings one by one, especially to solve the key problem of lacking a strong coordination mechanism in daily work. Fourth, we should pursue excellence and consolidate the "suitable" mechanism proven in the process of coping with the COVID-19, so that efficient mechanisms to deal with major issues can be used in routine work, and efforts should be made to consolidate the advantages of prevention and control of infectious diseases and emergency response, so as to achieve the balanced development of regions categories and units. Finally, it is necessary to strengthen the coordination of government and research institutions, in the aspects of technological innovation, talent team building and accurate consulting services, and work together to pursue a suitable and strong system to realize the modernization of the health system and capacity for governance.
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The COVID-19 epidemic fully reflects the importance of surveillance and early warning of infectious diseases, and also puts forward higher requirements for us to further improve epidemic surveillance to achieve early detection, early identification, early reporting and early disposal of various pathogens. In this paper, we reviewed the development of the integrated surveillance system for infectious diseases in Shanghai in recent years, illustrated the approach of integrated surveillance based on syndromes and events, and initially summarized the key results of the integrated surveillance, expanding the scope of surveillance, improving sensitivity and enhancing the capacity of the system. Moreover, considering the requirements regarding the public health system, we provide some thoughts and suggestions on further expanding of the integrated surveillance, continuously strengthening the integration of public health surveillance with clinical diagnosis and treatment, laboratory capacity development, and public health information technology.
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Public Health Emergencies provides a current overview of public health emergency preparedness and response principles with case studies highlighting lessons learned from recent natural and man-made disasters and emergencies. Designed for graduate and advanced undergraduate public health students, this book utilizes the 10 essential services of public health as performance standards and foundational competencies from the Council on Education for Public Health to assess public health systems. It emphasizes the roles and responsibilities of public health careers in state and local health departments as well as other institutions and clarifies their importance during health-related emergencies in the community. Written by prominent experts, including health professionals and leaders on the frontlines, this textbook provides the framework and lessons for understanding the public health implications of disasters, emergencies, and other catastrophic events, stressing applied understanding for students interested in pursuing public health preparedness roles. Practical in its approach, Part One begins with an introduction to the fundamentals of public health emergency preparedness with chapters on community readiness, all-hazards preparedness design, disaster risk assessments, and emergency operation plans. Part Two covers a range of public health emergency events, including hurricanes, tornadoes, earthquakes, disease outbreaks and pandemics, accidents and chemical contamination, nuclear and radiological hazards, extreme heat events, and water supply hazards. The final part addresses special considerations, such as how the law serves as a foundation to public health actions;preparedness considerations for persons with disabilities, access, and functional needs;children and disasters;and a chapter evaluating emerging and evolving threats. Throughout, chapters convey the roles of front-line, supervisory, and leadership personnel of the many stakeholders involved in preparedness, response, and recovery efforts to demonstrate decision-making in action. © 2022 Springer Publishing Company, LLC.
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Background: In modern health systems, emergency services (ES) constitute one of the cornerstones of health care, and they have an essential role in the conception of current health services. The objective of this work was to analyze the effect of sociodemographic characteristics and clinical factors in the use of ES.
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The pandemic declared by SARS-CoV-2 has meant a crisis in the health system that forced the urgent implementation of preventive public health measures. The respiratory transmission virus remains stable on surfaces, being able to spread by air in respiratory droplets or in procedures that generate aerosols. Dental activity is one of the professional sectors with the highest exposure index, both due to the generation of aerosols in most interventions, as well as the impossibility of maintaining a safe distance between patients and professionals. The postponement of scheduled and non-urgent healthcare activities in dental offices is one of the measures implemented to reduce the risk that it posed for the health and well-being of citizens. This report addresses the recommendations and measures to be taken into account to minimize risks in the Oral Health Units of the Andalusian Public Health System, to address the oral pathology of the population assigned in the scenario of improvement of the pandemic and its partial lack of confinement.
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In the Valencia Autonomous Community, the fight against the pandemic, in the workplace, has been articulated around joint action between the occupational health services and the Valencian public health system, promoted and coordinated by Public Health. There was experience in similar activities, but a great effort has been required in external and internal coordination, in adapting activities and information systems. Occupational risk prevention services have played an important role in the epidemiological surveillance and control of COVID-19 in companies and are also participating in vaccination. Only in the period September-December 2020, they received 67,239 cases of workers for contact studies, reported 3,059 confirmed cases and 1,206 suspected cases, determined 8,118 close work contacts and made 9,854 reports of leave due to special sensitivity. The Mutual for work-related injury and occupational disease insurance, which collaborated by vaccinating private health professionals in non-hospital centers, have declared 33,247 doses of vaccines administered. Part of the experience, the main activities carried out in the work environment, the joint work and some results are described.
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Background: The study was motivated by the need to understand the high number of deaths caused by COVID-19 in the global pandemic declared since December 2019, and how it impacted differently in European countries. The hypothesis was that less investment in the public health system, the number of doctors per inhabitant and the number of hospital beds available to the population led to a higher number of deaths after the arrival of COVID-19 in each country studied. The objective was to analyze the relationship between the number of deaths from COVID-19 in the global pandemic declared since December 2019 and health policies and investment in European countries.